UNKNOWN

FEED

The Coding Audit Specialist position conducts quality assurance activities to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and Department of Health Services (DHS); identifies deficiencies and provides management with an analysis of outcomes and tools for improving accuracy in coding. Responsible for auditing medical record documentation to determine appropriate diagnostic coding for services provided, taking into account the AMA CPT coding guidelines, ICD‐9 & ICD‐10 Coding Guidelines, CMS Medicare, HHS, and DHS BadgerCare Plus risk adjustment policy and Hierarchical Condition Category Coding.

HOUR

Sanford Health

Coding Audit Specialist, Health Plan

Be a Trusted Partner: Develop and nurture long-term relationships with key decision-makers, building credibility and positioning Harris as the acquirer of choice. What Your Impact Will Be: Develop the M&A Pipeline: Proactively identify and source software companies that align with our investment goals, using your initiative to build a robust pipeline of opportunities.

YEAR

Harris Computer Systems

(Remote) Corporate Development Associate

Graduate from a nationally accredited nursing program required, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Conduct review of clinical-based denials (i.e. Medical Necessity, Level of Care) within required timeframes utilizing clinical criteria sets, knowledge of payor regulations, and considerable clinical judgment, to determine appropriateness of care.

RN Lead Utilization Management Specialist - Appeals

IRecruitee

FULL_TIME

OTHER

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. The ideal candidate possesses deep technical expertise in the Appian platform, strong SQL skills, and a proven ability to thrive in Agile and SAFe environments.

MAXIMUS provides business services to help governments operate health and human services programs, mostly at the state and national levels. The company's health services segment offers outsourced program management and administrative services,

Maximus

Appian Developer

equestftpin

Branding and Marketing Manager position supports the development and execution of enterprise brand and integrated marketing strategy, helping translate strategic direction into compelling campaigns, content, digital experiences, and market-facing activation. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.

Senior Branding and Marketing Manager (Hybrid Remote: McLean, VA/DC Area)

This role partners closely with executive stakeholders, business leaders, and technical teams to ensure the successful implementation, operation, and continuous improvement of complex enrollment and premium processing technology and business operations programs. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.

Senior Program Director, Government Programs (Remote)

2 Supporting new entrants through coaching - engaging with new starters individually and in group sessions to build confidence, competence, and clinical capability. This will be a mixture of observations of assessments, completion of assessments, coaching, supporting new entrant training as needed and liaising with management.

Clinical Support Coach - Stage 3 (WCA)

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. This role combines traditional project management experience with independent verification and validation (IV&V) responsibilities to evaluate program governance, project controls, risk management, schedule performance, quality management, and overall delivery effectiveness.

IV&V Project Manager

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Current certification in one of the following: Certified Strength and Conditioning Specialist (CSCS), Strength and Conditioning Coach Certified (SCCC), Physical Therapist, Certified Consultant through the Association for Applied Sport Psychology (CC-AASP), Registered Dietitian (RD), or Registered Dietitian Nutritionist (RDN).

Senior Human Performance Advisor (POTFF)

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. We are looking for a highly skilled technical Lead Appian Developer to drive the design, development, and implementation of complex case management and workflow automation solutions in a federal environment.

Lead Appian Developer

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. BA seeks to become a subject matter exert in the areas assigned, and to do so must learn their assignments, asking questions, researching ambiguous items leading to full understanding of work areas/assignments ** This is a fully remote position.

Sr Analyst - Business Analysis

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Troubleshooting, test automation and code coverage, test-data creation, debugging across Java/scripts/xPression, targeted code refactoring and script consolidation, and other technical-debt remediation necessary to maintain reliable and supportable notice processing.

Senior JAVA Developer - Full Time

The role collaborates closely with Operations, Knowledge Management, Quality, Technology, and program stakeholders to rapidly gather requirements, validate content, incorporate changes, and ensure training prepares CSRs to accurately and consistently support program requirements at launch and throughout ongoing operations. Instructional Designer supports the U.S. Office of Personnel Management’s (OPM) administration of the FEHB Protection Act by designing and developing training solutions for Customer Service Representatives supporting Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Program enrollees.

Sr Specialist - Instructional Design (Limited-Service, Remote)

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - Define and implement development plans for assigned projects in order to increase staff’s knowledge and skills in the areas relevant to the team’s work such as; project management, analysis, software development, or testing.

Mac Engineering Manager

Active New Hampshire independent clinical licensure as a Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Social Worker (LCSW), Licensed Clinical Mental Health Counselor (LCMHC), or Licensed Marriage and Family Therapist (LMFT) or comparable independently practicing behavioral health clinician. - Active independent clinical licensure as a Licensed Independent Clinical Social Worker (LICSW), Licensed Clinical Social Worker (LCSW), Licensed Clinical Mental Health Counselor (LCMHC), or Licensed Marriage and Family Therapist (LMFT) or comparable independently practicing behavioral health clinician.

Licensed Clinical Assessor - (Remote)

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. This position is ideal for professionals with backgrounds in project coordination, PMO support, business analysis, quality assurance, consulting, or technology project delivery who are interested in developing expertise in program oversight, governance, and independent assessment services.

Jr. IV&V Analyst

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. -Strong communication, leadership, presentation, and interpersonal skills are required to enable an effective interface with other departments, all levels of management, professional and support staff, customers, potential customers, and government representatives.

Federal Senior Subcontracts Manager (Remote)

Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. We are looking for a highly skilled Technical Lead/Senior Appian Developer to drive the design, development, and implementation of complex case management and workflow automation solutions in a federal environment.

Appian Lead Developer

In this capacity, you will help synthesize input from across the business to produce credible, differentiated, and fast-turn responses to customer information requests, briefings, demonstrations, white papers, RFIs, and RFP inputs supporting agencies such as CMS, HRSA, VA, HHS, and state Medicaid programs. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.

Mission Technology Champion /Federal Health - RFI & RFP, Gov Proposal

Knowledge Analyst supports the U.S. Office of Personnel Management’s (OPM) administration of the FEHB Protection Act by developing, maintaining, and governing knowledge resources used by Customer Service Representatives (CSRs) supporting Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) Program enrollees. Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment.

Remote Jobs in Sioux Falls, SD

Coding Audit Specialist, Health Plan Sanford Health

(Remote) Corporate Development Associate Harris Computer Systems

RN Lead Utilization Management Specialist - Appeals Sanford Health

Appian Developer Maximus

Senior Branding and Marketing Manager (Hybrid Remote: McLean, VA/DC Area) Maximus

Senior Program Director, Government Programs (Remote) Maximus

Clinical Support Coach - Stage 3 (WCA) Maximus

IV&V Project Manager Maximus

Senior Human Performance Advisor (POTFF) Maximus

Lead Appian Developer Maximus

Sr Analyst - Business Analysis Maximus

Senior JAVA Developer - Full Time Maximus

Sr Specialist - Instructional Design (Limited-Service, Remote) Maximus

Mac Engineering Manager Maximus

Licensed Clinical Assessor - (Remote) Maximus

Jr. IV&V Analyst Maximus

Federal Senior Subcontracts Manager (Remote) Maximus

Appian Lead Developer Maximus

Mission Technology Champion /Federal Health - RFI & RFP, Gov Proposal Maximus

Sr Analyst - Knowledge Management (Remote) Maximus

Similar Job Searches

Stand out to leading employers.